| NPI | 1780236935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHELLE JUNTUNEN Warden 701-579-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2019-07-09 |